V-Cod
Generic Name
Codeine Phosphate + Promethazine Hydrochloride
Manufacturer
Veritas Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| v cod syrup | ৳ 80.00 | N/A |
Description
Overview of the medicine
V-Cod Syrup is a combination medication containing Codeine Phosphate, an opioid antitussive, and Promethazine Hydrochloride, an antihistamine. It is primarily used for the symptomatic relief of cough and associated allergic conditions.
Uses & Indications
Dosage
Adults
5-10 mL every 4-6 hours as needed, not to exceed 60 mL in 24 hours.
Elderly
Start with lower doses; caution due to increased sensitivity and potential for side effects. Dosage adjustment may be necessary.
Children
Not recommended for children under 12 years. For adolescents 12-18 years: 5-10 mL every 4-6 hours as needed, not to exceed 60 mL in 24 hours.
Renal_impairment
Use with caution. Dose reduction may be needed depending on the degree of renal impairment.
How to Take
For oral use only. Administer with a calibrated measuring device to ensure accurate dosing. May be taken with or without food.
Mechanism of Action
Codeine Phosphate acts centrally by suppressing the cough reflex in the medulla. Promethazine Hydrochloride is a phenothiazine derivative that acts as a potent H1-receptor antagonist, exhibiting sedative, anticholinergic, and antiemetic properties.
Pharmacokinetics
Onset
Codeine: 30-60 minutes (oral). Promethazine: Approximately 20 minutes (oral).
Excretion
Both codeine and promethazine, along with their metabolites, are primarily excreted via the kidneys.
Half life
Codeine: 2-4 hours. Promethazine: 10-14 hours.
Absorption
Codeine is well absorbed from the gastrointestinal tract. Promethazine is well absorbed after oral administration.
Metabolism
Codeine is metabolized in the liver, primarily by CYP2D6 to morphine (active metabolite) and by CYP3A4 to norcodeine. Promethazine undergoes extensive first-pass metabolism in the liver.
Side Effects
Contraindications
- •Hypersensitivity to codeine, promethazine, or any component of the syrup.
- •Children younger than 12 years of age (due to the risk of respiratory depression and death).
- •Post-operative pain management in children and adolescents after tonsillectomy and/or adenoidectomy.
- •Patients with acute asthma, respiratory depression, or severe obstructive pulmonary disease.
- •Patients with known or suspected paralytic ileus.
- •Comatose states, CNS depression, or severe liver disease.
- •Patients with narrow-angle glaucoma or prostatic hypertrophy (due to anticholinergic effects of promethazine).
- •Lactating women.
Drug Interactions
Adrenergic Drugs
May cause paradoxical hypertension and tachycardia.
Monoamine Oxidase Inhibitors (MAOIs)
Concomitant use with promethazine can lead to increased anticholinergic effects and CNS depression. Avoid use within 14 days of MAOI therapy.
CYP2D6 Inducers (e.g., rifampin, phenobarbital)
May increase the conversion of codeine to morphine, leading to increased risk of opioid toxicity.
CYP2D6 Inhibitors (e.g., quinidine, fluoxetine, paroxetine)
May reduce the analgesic and antitussive effect of codeine by inhibiting its conversion to morphine, leading to reduced efficacy.
Anticholinergic Drugs (e.g., tricyclic antidepressants, atropine)
Increased risk of anticholinergic side effects such as dry mouth, blurred vision, urinary retention, and constipation.
CNS Depressants (e.g., alcohol, benzodiazepines, other opioids, sedatives, hypnotics)
Increased risk of CNS depression, respiratory depression, hypotension, and profound sedation. Concomitant use should be avoided or used with extreme caution with dose reductions.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of codeine overdose include severe respiratory depression, somnolence progressing to stupor or coma, pinpoint pupils, skeletal muscle flaccidity, cold and clammy skin, and sometimes hypotension and bradycardia. Symptoms of promethazine overdose include deep sleep, coma, convulsions, and anticholinergic effects such as dry mouth, blurred vision, and urinary retention. Management involves supportive care, maintaining a patent airway, providing ventilatory support, and administering opioid antagonists like naloxone for codeine overdose. For promethazine overdose, treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy: Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Prolonged use during pregnancy can lead to neonatal opioid withdrawal syndrome. Lactation: Not recommended. Both codeine and promethazine are excreted into breast milk and can cause serious adverse reactions, including respiratory depression, in nursing infants.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years (24-36 months) from the manufacturing date when stored correctly.
Availability
Available in pharmacies and hospitals in Bangladesh.
Approval Status
Approved by Directorate General of Drug Administration (DGDA), Bangladesh
Patent Status
Off-patent
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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